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Submitted by:
Jho Ann Labor
BSN- IV
Submitted to:
Mrs. Dapnhny Hatud
Arthritis
Age
Decreased muscle strength
Obesity
Possible genetic risk
Early in disease process, OA is difficult to dx from RA
Hx of Trauma to joint
Signs and Symptoms
Female gender
Age 20-50 years
Genetic predisposition
Epstein Barr virus
Stress
Diagnostic Test
Rheumatoid Factor antibody- High titers correlate with severe disease, 80% pts.
Antinuclear Antibody (ANA) Titer- positive titer is associated with RA.
C- reactive protein- 90% pts.
ESR: Elevated, moderate to severe elevation
Arthocentesis- synovial fluid aspirated by needle
Signs and Symptoms
Joints- bilateral and symmetric stiffness, tenderness, swelling and temp. Changes in
joint.
Pain at rest and with movement
Pulses- check peripheral pulses, use Doppler if necessary, check capillary refill.
Edema- observe, report and record amt. and location of edema.
ROM, muscle strength, mobility, atrophy
Anorexia, weight loss
Fever- generally low grade
Treatment
Sjogrenss syndrome
Joint deformity
Vasculitis
Cervical subluxation
Gouty Arthritis
- Very painful joint inflammation, swollen and reddened
Primary -Inborn error of uric acid metabolism- increases production and interferes with
excretion of uric acid
Secondary - Hyperuricemia caused by another disease
Excess uric acid converted to sodium urate crystals and precipitate from blood and become
deposited in joints- tophi or in kidneys, renal calculi
Treatment:
Osteoporosis
- Metabolic bone disorder- progressively porous, brittle, fragile bones, low bone
density, susceptible to fractures
- Occurs in postmenopausal women
- Bone resorption (osteoclast) > bone formation (osteoblast) activity
- Dowagers hump progressive kyphosis gradual collapse of vertebrae.
- Post-menopausal lose height, c/o fatigue.
Diagnostic tests:
Radiographs,
Dexa scans
Risk Factors
HRT-Raloxifene (Evista)
PTH- Forteo Subcut
Bisphosphonates- Fosamax,Boniva, Actonal
Reclast, Zometia
Calcitonin, Vit D
NSAIDs
Osteomyelitis
- Infection of the bone
Endogenous:
- Extension of soft tissue infection- infected pressure ulcers or incision.
- Blood borne (spread from other body sites)
- At risk- poorly nourished, elderly, obese, impaired immune systems, corticosteroid
therapy, and chronic illnesses.
- Prevention- proper tx. of infections, aseptic post op wound care
Exogenous:
- Organism enters from outside the body. Eg. Open fx
Signs and symptoms
High fever, chills, increased HR, general malaise, swelling, tenderness, heat and
erythema, painful movement.
Draining ulcers, bone pain
Diagnostic result:
increased WBCs
elevated ESR
positive blood cultures
X-rays
bone scan
MRI
Treatment
Complete- a break across the entire cross- section and is frequently displaced.
Incomplete (Greenstick)-break occurs through only part of the cross-section of the
bone.
Closed Fracture (simple) - doesnt break through the skin.
Open fracture (compound) - extends through the skin
Comminuted- splintered into fragments
Depressed- fragment(s) is(are) in driven
Hip fractures
- High incidence in elderly due to risk for falls, osteoporosis.
- Intracapsular- Neck of femur, may damage blood supply, aseptic necrosis.
- Extracapsular- base of neck and lesser trochanter of femur- heals more easily.
- ORIF- open reduction with internal fixation.
Symptoms of Fractures
Deformity
Swelling
Bruising
Muscle spasms
Tenderness
Pain
Impaired sensation
Loss of normal function
Abnormal mobility
Crepitus
Shock
Abnormal X-rays
Nursing Diagnoses